Prognostic value of circulating tumor cells according to immunohistochemically defined molecular subtypes in advanced breast cancer

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Abstract

Background: Breast cancer is a heterogeneous disease. Circulating tumor cell (CTC) enumeration might be useful to identify different risk categories within each molecular subtype. Methods: We retrospectively analyzed 203 consecutive patients with metastatic breast cancer with baseline CTC enumeration performed with CellSearch (Veridex Corp, Warren, NJ) between March 2005 and July 2011. Patients were categorized into 3 prognostic groups based on the number of CTCs (0, 1-4, and <5) and into 5 categories based on tumor biological characteristics: luminal-A (estrogen receptor [ER] and progesterone receptor [PR] > 1%, grade 1/2, human epidermal growth factor 2 [HER2]-negative [HER2-], Ki67 value <14%); luminal-B (ER and/or PR > 1%, grade 3, HER2-, Ki67 value > 14%); luminal-B HER2-positive [HER2+] (ER and/or PR > 1%, any grade, HER2 +, Ki-67 value any); HER2+ (HER2 overexpressed/ fluorescence in situ hybridization [FISH] amplified, ER and PR absent); triple negative (TN) (ER and PR 0%, HER2 not overexpressed/FISH not amplified). Results: Median age was 57 years (range 31-78 years). Twenty-seven patients (13.3%) had luminal-A category, 105 (51.7%) patients had luminal-B, 29 (14.3%) patients had luminal-B HER2+, 24 patients (11.8%) had HER2 +, and 18 patients (8.9%) had TN. CTCs were mostly found in patients with luminal-A/luminal-B HER2- subtype. At multivariable analysis, CTC count was a significant predictive factor for overall survival (OS) in all molecular subtypes (log-rank P +, seem to perform better compared with other categories. Conclusion: These findings confirm CTCs as an important prognostic factor for metastatic breast cancer in all molecular subtypes. Larger studies could help identify metastatic breast cancer subgroups in which CTC analysis would be particularly useful.

Original languageEnglish
Pages (from-to)340-346
Number of pages7
JournalClinical Breast Cancer
Volume12
Issue number5
DOIs
Publication statusPublished - 2012

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Circulating Neoplastic Cells
Epidermal Growth Factor
Breast Neoplasms
Fluorescence In Situ Hybridization

Keywords

  • Advanced breast cancer
  • Circulating tumor cells
  • HER2 overexpression
  • Luminal A
  • Luminal B
  • Molecular subtypes
  • Triple negative

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

@article{a35b329e98294c248baa208dbd78440b,
title = "Prognostic value of circulating tumor cells according to immunohistochemically defined molecular subtypes in advanced breast cancer",
abstract = "Background: Breast cancer is a heterogeneous disease. Circulating tumor cell (CTC) enumeration might be useful to identify different risk categories within each molecular subtype. Methods: We retrospectively analyzed 203 consecutive patients with metastatic breast cancer with baseline CTC enumeration performed with CellSearch (Veridex Corp, Warren, NJ) between March 2005 and July 2011. Patients were categorized into 3 prognostic groups based on the number of CTCs (0, 1-4, and <5) and into 5 categories based on tumor biological characteristics: luminal-A (estrogen receptor [ER] and progesterone receptor [PR] > 1{\%}, grade 1/2, human epidermal growth factor 2 [HER2]-negative [HER2-], Ki67 value <14{\%}); luminal-B (ER and/or PR > 1{\%}, grade 3, HER2-, Ki67 value > 14{\%}); luminal-B HER2-positive [HER2+] (ER and/or PR > 1{\%}, any grade, HER2 +, Ki-67 value any); HER2+ (HER2 overexpressed/ fluorescence in situ hybridization [FISH] amplified, ER and PR absent); triple negative (TN) (ER and PR 0{\%}, HER2 not overexpressed/FISH not amplified). Results: Median age was 57 years (range 31-78 years). Twenty-seven patients (13.3{\%}) had luminal-A category, 105 (51.7{\%}) patients had luminal-B, 29 (14.3{\%}) patients had luminal-B HER2+, 24 patients (11.8{\%}) had HER2 +, and 18 patients (8.9{\%}) had TN. CTCs were mostly found in patients with luminal-A/luminal-B HER2- subtype. At multivariable analysis, CTC count was a significant predictive factor for overall survival (OS) in all molecular subtypes (log-rank P +, seem to perform better compared with other categories. Conclusion: These findings confirm CTCs as an important prognostic factor for metastatic breast cancer in all molecular subtypes. Larger studies could help identify metastatic breast cancer subgroups in which CTC analysis would be particularly useful.",
keywords = "Advanced breast cancer, Circulating tumor cells, HER2 overexpression, Luminal A, Luminal B, Molecular subtypes, Triple negative",
author = "Elisabetta Munzone and Edoardo Botteri and Sandri, {Maria Teresa} and Angela Esposito and Laura Adamoli and Laura Zorzino and Angela Sciandivasci and Cassatella, {Maria Cristina} and Nicole Rotmensz and Gaetano Aurilio and Giuseppe Curigliano and Aron Goldhirsch and Franco Nol{\`e}",
year = "2012",
doi = "10.1016/j.clbc.2012.07.001",
language = "English",
volume = "12",
pages = "340--346",
journal = "Clinical Breast Cancer",
issn = "1526-8209",
publisher = "Elsevier",
number = "5",

}

TY - JOUR

T1 - Prognostic value of circulating tumor cells according to immunohistochemically defined molecular subtypes in advanced breast cancer

AU - Munzone, Elisabetta

AU - Botteri, Edoardo

AU - Sandri, Maria Teresa

AU - Esposito, Angela

AU - Adamoli, Laura

AU - Zorzino, Laura

AU - Sciandivasci, Angela

AU - Cassatella, Maria Cristina

AU - Rotmensz, Nicole

AU - Aurilio, Gaetano

AU - Curigliano, Giuseppe

AU - Goldhirsch, Aron

AU - Nolè, Franco

PY - 2012

Y1 - 2012

N2 - Background: Breast cancer is a heterogeneous disease. Circulating tumor cell (CTC) enumeration might be useful to identify different risk categories within each molecular subtype. Methods: We retrospectively analyzed 203 consecutive patients with metastatic breast cancer with baseline CTC enumeration performed with CellSearch (Veridex Corp, Warren, NJ) between March 2005 and July 2011. Patients were categorized into 3 prognostic groups based on the number of CTCs (0, 1-4, and <5) and into 5 categories based on tumor biological characteristics: luminal-A (estrogen receptor [ER] and progesterone receptor [PR] > 1%, grade 1/2, human epidermal growth factor 2 [HER2]-negative [HER2-], Ki67 value <14%); luminal-B (ER and/or PR > 1%, grade 3, HER2-, Ki67 value > 14%); luminal-B HER2-positive [HER2+] (ER and/or PR > 1%, any grade, HER2 +, Ki-67 value any); HER2+ (HER2 overexpressed/ fluorescence in situ hybridization [FISH] amplified, ER and PR absent); triple negative (TN) (ER and PR 0%, HER2 not overexpressed/FISH not amplified). Results: Median age was 57 years (range 31-78 years). Twenty-seven patients (13.3%) had luminal-A category, 105 (51.7%) patients had luminal-B, 29 (14.3%) patients had luminal-B HER2+, 24 patients (11.8%) had HER2 +, and 18 patients (8.9%) had TN. CTCs were mostly found in patients with luminal-A/luminal-B HER2- subtype. At multivariable analysis, CTC count was a significant predictive factor for overall survival (OS) in all molecular subtypes (log-rank P +, seem to perform better compared with other categories. Conclusion: These findings confirm CTCs as an important prognostic factor for metastatic breast cancer in all molecular subtypes. Larger studies could help identify metastatic breast cancer subgroups in which CTC analysis would be particularly useful.

AB - Background: Breast cancer is a heterogeneous disease. Circulating tumor cell (CTC) enumeration might be useful to identify different risk categories within each molecular subtype. Methods: We retrospectively analyzed 203 consecutive patients with metastatic breast cancer with baseline CTC enumeration performed with CellSearch (Veridex Corp, Warren, NJ) between March 2005 and July 2011. Patients were categorized into 3 prognostic groups based on the number of CTCs (0, 1-4, and <5) and into 5 categories based on tumor biological characteristics: luminal-A (estrogen receptor [ER] and progesterone receptor [PR] > 1%, grade 1/2, human epidermal growth factor 2 [HER2]-negative [HER2-], Ki67 value <14%); luminal-B (ER and/or PR > 1%, grade 3, HER2-, Ki67 value > 14%); luminal-B HER2-positive [HER2+] (ER and/or PR > 1%, any grade, HER2 +, Ki-67 value any); HER2+ (HER2 overexpressed/ fluorescence in situ hybridization [FISH] amplified, ER and PR absent); triple negative (TN) (ER and PR 0%, HER2 not overexpressed/FISH not amplified). Results: Median age was 57 years (range 31-78 years). Twenty-seven patients (13.3%) had luminal-A category, 105 (51.7%) patients had luminal-B, 29 (14.3%) patients had luminal-B HER2+, 24 patients (11.8%) had HER2 +, and 18 patients (8.9%) had TN. CTCs were mostly found in patients with luminal-A/luminal-B HER2- subtype. At multivariable analysis, CTC count was a significant predictive factor for overall survival (OS) in all molecular subtypes (log-rank P +, seem to perform better compared with other categories. Conclusion: These findings confirm CTCs as an important prognostic factor for metastatic breast cancer in all molecular subtypes. Larger studies could help identify metastatic breast cancer subgroups in which CTC analysis would be particularly useful.

KW - Advanced breast cancer

KW - Circulating tumor cells

KW - HER2 overexpression

KW - Luminal A

KW - Luminal B

KW - Molecular subtypes

KW - Triple negative

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U2 - 10.1016/j.clbc.2012.07.001

DO - 10.1016/j.clbc.2012.07.001

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SN - 1526-8209

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